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SRS: Bracing Effective for Adolescent Idiopathic Scoliosis

 
THURSDAY, Sept. 19 (HealthDay News) -- For patients with adolescent idiopathic scoliosis, bracing correlates with decreased progression of high-risk curves, according to a study published online Sept. 19 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the Scoliosis Research Society, held from Sept. 18 to 21 in Lyon, France.

Stuart L. Weinstein, M.D., from the University of Iowa in Iowa City, and colleagues conducted a multicenter study involving 242 patients with adolescent idiopathic scoliosis to examine the effects of bracing. One hundred sixteen patients were randomized to bracing or observation and 126 chose between bracing and observation. Participants in the bracing groups were told to wear a brace for 18 hours per day or more.

Due to the efficacy of bracing, the trial was stopped early. The researchers found that the rate of treatment success (skeletal maturity without curve progression of 50 degrees or more) was 72 percent after bracing compared with 48 percent after observation (propensity-score-adjusted odds ratio, 1.93) in an analysis including both the randomized and preference cohorts. The rate of success was 75 percent among patients randomized to bracing, compared with 42 percent for those randomized to observation (odds ratio, 4.11) in intention-to-treat analysis. Longer hours of brace wear correlated significantly with higher rates of treatment success.

"Bracing significantly decreased the progression of high-risk curves to the threshold for surgery in patients with adolescent idiopathic scoliosis," the authors write. "The benefit increased with longer hours of brace wear."

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